Knee immobilization on meniscal healing after suture: an experimental study in sheep

Immobilization and nonweightbearing may influence the healing of sutured meniscal lesions in the avascular zone. In 12 sheep, 3 to 4 months of age, a 0.5-cm longitudinal lesion was made in the middle segment and posterior portion of the medial meniscus of the left knee in the avascular zone. The lesion was sutured immediately. The knees of six sheep were immobilized with a monolateral external fixator, which crossed the knee, and the knees in the other six sheep were not immobilized. The animals were sacrificed 6 weeks after the operation. Specimens from the anterior meniscus were used for histologic and vascular studies, and the posterior meniscus was used for mechanical testing. Repair was observed in two of 12 sheep in the form of fibrous tissue. Fibrochondrocytes and synovial cells were involved. Meniscal fibrochondrocytes from the nearest meniscal tissue, synovial cells from the femoral and tibial meniscal surfaces, and fibroblastic cells migrating through the suture channel provide cell access to the meniscus lesion. Sutured menisci, immobilized or not, support less than 50% of a normal load and are mechanically weak.